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ENT Week 1 2017/18 > 4: ENT pathology > Flashcards

4: ENT pathology Flashcards

1
Q

What lines the ear canal?

A

Epidermis (stratified squamous epithelium)

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2
Q

What are ceruminous glands?

A

Produce earwax

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3
Q

Any pathology which affects the ___ can also affect the ear canal.

A

Skin

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4
Q

What kind of epithelium lines the middle ear?

A

Columnar epithelium

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5
Q

What is the Organ of Corti?

A

Part of cochlea which contains hair cells

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6
Q

What type of epithelium is found in the nasal vestibule?

A

Keratinised squamous epithelium

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7
Q

What type of epithelium is found in the nasal cavities and sinuses?

What is it exactly the same as?

A

Schneiderian epithelium

Respiratory epithelium - pseudostratified ciliated columnar epithelium with goblet cells

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8
Q

What types of epithelium are found in the throat?

A

Respiratory epithelium

Squamous epithelium for vocal cords

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9
Q

What type of glands are the salivary glands?

A

Exocrine glands

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10
Q

What do the serous cells and mucus cells of the salivary glands secrete?

A

Serous - digestive enzymes e.g alpha amylase

Mucus - clear grey sticky mucus

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11
Q

What is otitis media?

A

Inflammation of the middle ear

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12
Q

What usually causes otitis media?

A

Viruses

Occasionally bacteria, if chronic, suspect Pseudomonas

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13
Q

What is a cholesteatoma?

A

NOT a TUMOUR and DOESN’T CONTAIN CHOLESTEROL

Production of keratinised squamous epithelium in middle ear producing nasty discharge

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14
Q

Cholesteatoma involves the metaplasia of ___ ___ epithelium into ___ ___ epithelium.

A

cuboidal glandular

squamous keratinised

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15
Q

What is a nerve tumour of the nerve which controls balance?

A

Vestibular schwannoma

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16
Q

Tumours at which angle are almost always benign vestibular schwannomas?

A

Cerebellopontine angle

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17
Q

What do schwannomas look like on histology?

A

Elongated nuclei

Verocay bodies - sandwiches of cells between darker palisades

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18
Q

What genetic disease predisposes you to bilateral schwannomas?

A

Neurofibromatosis type 2

(also cafe au lait spots, axillary freckles, Lisch nodules in the eye)

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19
Q

What sign is seen in the eyes in neurofibromatosis type 2?

A

Lisch nodules

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20
Q

What is the mode of inheritance of NF type 2?

A

Autosomal dominant

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21
Q

What are common benign masses found in the nose?

Which group are they NOT common in?

A

Nasal polyps

Children

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22
Q

If you encounter a child with nasal polyps, what should you consider?

A

Cystic fibrosis

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23
Q

Are nasal polyps painful?

A

No

24
Q

What type of vasculitis has a lot of midline symptoms (i.e ENT, renal)?

A

Wegener’s granulomatosis

Now called granulomatosis with polyangiitis

25
Q

Which antibodies are detected in

a) microscopic polyangiitis
b) granulomatosis with polyangiitis (Wegener’s)?

A

a) pANCA

b) cANCA

26
Q

What is one of the most common reasons for nasal ulceration?

A

Cocaine

27
Q

What happens to blood vessels in granulomatosis with polyangiitis?

A

Occluded by giant inflammatory cells

28
Q

What are some benign tumours of the nasal cavity?

A

Squamous cell papillomas

Schneiderian papillomas

29
Q

What are some malignant lesions of the nasal cavity?

A

Squamous cell carcinoma

30
Q

What are malignant tumours of glandular epithelium?

A

Adenocarcinoma

31
Q

What is a rare malignant tumour of the nasopharynx?

What virus is strongly associated with it?

A

Nasopharyngeal carcinoma

Epstein-Barr virus

32
Q

Which virus is associated with blood cancers and epithelial malignancy?

A

EBV

remember EBV causes glandular fever (which can result in lymphoma) and nasopharyngeal carcinoma

33
Q

Which part of the cell cycle does EBV trigger?

A

Transition from G0 to G1, starts growth

34
Q

What are benign tumours of the vocal cords which form in response to smoking, trauma and inflammation?

A

Laryngeal polyps

35
Q

What ulcer is an inflammatory response to trauma of the vocal cords?

A

Contact ulcer

36
Q

What benign tumour forms in the larynx and is associated with a virus?

Which specific strains of the virus?

A

Squamous cell papilloma

HPV types 6 and 11

37
Q

What do papillomas look like?

A

Finger-like projections

“papillomatous”

38
Q

What are paraganglioma?

A

Tumours arising from neuroendocrine cells

39
Q

Which types of paraganglioma are found

a) above the diaphragm
b) below the diaphragm?

A

Chromaffin negative - don’t secrete catecholamines, major blood vessels, head and neck

Chromaffin positive - your phaechromocytoma type tumours which secrete catecholamines

40
Q

What genetic disease are numerous phaeochromocytomas a feature of?

What is its mode of inheritance?

A

MEN2

Autosomal dominant

41
Q

What is the most common malignant tumour of the head and neck?

A

Squamous cell carcinoma

42
Q

What are the lifestyle factors commonly associated with squamous cell carcinoma?

A

Smoking

Alcohol

43
Q

Which type of HPV is associated with squamous cell carcinoma?

A

Type 16

(remember 6 and 11 are the papilloma ones)

44
Q

What pathways does type 16 HPV disrupt?

A

p53

Rb

45
Q

How is squamous cell carcinoma of the head and neck treated?

A

Radiotherapy

Chemotherapy

46
Q

What staging system is used for head and neck tumours?

A

TNM staging

47
Q

Which salivary gland is the most common for tumours?

A

Parotid glands

48
Q

Tumours in the (parotid / smaller) salivary glands are more likely to be malignant.

A

smaller glands

49
Q

What is a massive red flag for malignant tumours of the salivary glands?

A

Pain

means CN VII has been infiltrated

50
Q

What is the most common tumour of salivary glands?

A

Pleomorphic ADENOMA

(remember glandular)

51
Q

Where are pleomorphic adenomas usually found?

How are they treated?

A

Parotid glands

Excised due to risk of malignant transformation

52
Q

Pleomorphic adenoma is more common in (males / females) of which age?

A

Females

Older ( > 60)

53
Q

What is the second most common benign tumour of the parotid gland?

A

Warthin’s tumour

54
Q

What should make you suspicious of a malignant salivary gland tumour?

A

Painful

Lump in the neck

55
Q

Warthin’s tumour of the parotids is more common in (males / females) of which age?

What lifestyle choice are they associated with?

Are they unilateral or bilateral?

A

Men

Smoking

Bilateral

ENT Week 1 2017/18 (10 decks)

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